The EXACERBANTES Study (Exacerbation of Chronic Obstructive Pulmonary Disease According to the ANTES Proposal): Rationale, Goals and Design

The EXACERBANTES Study explores treatable traits in COPD exacerbations, aiming to improve risk assessment and support personalized clinical management.

EXACERBANTES Study: Treatable Traits in COPD Exacerbations

The Rationale Behind the EXACERBANTES Study

COPD exacerbations (ECOPD) are complex events that demand a personalized approach. A novel patient-centered approach focuses on the identification of treatable traits (TTs) has recently been proposed.

Objectives of the EXACERBANTES Study

The primary goal of the EXACERBANTES study is to systematically describe the distribution of TTs in patients with ECOPD attending primary care (PC) and hospital-based emergency care (HC).

Clinical Outcomes and Risk Prediction

Secondary goals include: (1) assessing the relationship between individual TTs and relevant clinical outcomes; (2) developing a predictive risk score based on TTs; (3) comparing the performance of different severity classifications; (4) validating these scores against the DECAF (Dyspnea, Eosinopenia, Consolidation, Acidosis, Atrial Fibrillation) index in hospitalized patients; (5) evaluating the feasibility of measuring FEV1 during exacerbations using handheld microspirometers; and (6) comparing lung function during the acute phase with measurements taken 90 days later.

Study Design and Patient Assessment

Prospective, multicenter, observational study involving patients diagnosed with ECOPD in PC and HC. The PC cohort will undergo routine and advanced testing including ECG, microspirometry, and capillary C-reactive protein (CRP). The HC cohort will undergo additional assessments such as blood tests, arterial blood gases, chest-X-test, and biomarkers (CRP, troponin T, NT-proBNP, D-dimer). Patients will be re-evaluated 90 days after the index event.

The estimated sample size for the primary objective is 397 patients.

The first patient was recruited on December 13, 2024; results are expected in the first quarter of 2026.

Clinical Implications of the EXACERBANTES Study

The EXACERBANTES study offers a framework to explore TTs in ECOPD and to develop a personalized, outcome-oriented treatment strategy.

Authors

Juan José Soler-Cataluña, Alberto Fernández-Villar, José Luis Izquierdo, Juan Luis García-Rivero, Borja G. Cosio, José Luis López-Campos, Marc Miravitlles, Alvar Agustí, on behalf of the EXACERBANTES study group

Fecha de publicación

July – September 2026

Categorías asociadas al artículo

Cohort Studies-Estudios de Cohorte, COPD-EPOC, Estudios-Studies, Exacerbations-Exacerbaciones, FEV1, Investigación, Lung function-Función pulmonar, Medicina personalizada - Personalized Medicine, Rasgos tratables-Treatable traits, Spirometry-Espirometría

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